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Aspects of the media and their relevance to bulimic attitudes and tendencies among female college students
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Eating Behaviors 9 (2008) 247 – 250
Short communication
Aspects of the media and their relevance to bulimic attitudes and tendencies among female college students Siobhan S. O'Riordan ⁎, Byron L. Zamboanga Department of Psychology, Clark Science Center, Smith College Northampton, MA 01063, United States Received 1 December 2006; accepted 16 March 2007
Abstract We examined whether media pressures would mediate the association between two dimensions of the media (source of information and internalization) and bulimic attitudes/tendencies. The study sample consisted of 106 female college students (M age = 19.9; range = 18–22). Participants completed anonymous, self-report measures on media influences on body image and appearance as well as disordered eating attitudes/behaviors. Findings showed that the association between two dimensions of the media (source of information and internalization) and bulimic attitudes/tendencies was mediated by perceived media pressures. Such findings highlight the significant influence of media pressures on bulimic attitudes/tendencies. Future research and prevention implications are discussed. © 2007 Published by Elsevier Ltd. Keywords: Bulimia Nervosa; Media; Eating disorders
In American society, there is a strong emphasis placed on body shape and appearance (Grigg, Bowman, & Redman, 1996). Unfortunately, the ideal body type/image encouraged by society is often ultra-thin and unrealistic and may therefore contribute to the prevalence of body distortion. These social influences are linked to disordered eating attitudes and behaviors, such as Bulimia Nervosa (BN) (Cusumano & Thompson, 1997). Prior research suggests that the prevalence of BN has increased and that nearly 3 out of 100 women are diagnosed with the disorder (Botta, 1999). According to Grigg et al. (1996), BN most commonly occurs at the end of adolescence, particularly among U.S. college students (Pelletier, Dion, & Levesque, 2004). The adverse health consequences of BN can include, but are not limited to, kidney failure and congestive heart failure (Hesse-Biber, Leavy, Quinn, & Zoino, 2006). Eating Disorders (ED) as a whole are more prevalent in women than men; in fact, 90–95% of those diagnosed with an ED are women (Hesse-Biber et al., 2006). Altogether, the adverse health consequences and the increased frequency of ED in this population highlight the need for continued research on disordered eating attitudes and behaviors. There are a number of sociocultural factors, such as the mass media, that contribute to the onset and maintenance of ED. Different aspects of the media can influence an individual's body perceptions. Prior research ⁎ Corresponding author. E-mail addresses: [email protected] (S.S. O'Riordan), [email protected] (B.L. Zamboanga). 1471-0153/$ - see front matter © 2007 Published by Elsevier Ltd. doi:10.1016/j.eatbeh.2007.03.004
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S.S. O'Riordan, B.L. Zamboanga / Eating Behaviors 9 (2008) 247–250
suggests that many women use the media for body image information and strategies to attain the ideal body type/ image (Botta, 1999; Stice, Schupak-Neuberg, Shaw, & Stein, 1994). For example, the ideal body type/image presented by the media is generally 15% smaller than the average woman (Hawkins, Richards, Granley, & Stein, 2004). In fact, Stice et al. (1994) found that individuals with BN learned their purging techniques directly from the media. Furthermore, some individuals internalize the messages in the media regarding the ideal body appearance; consequently, individuals modify their own body and behavior to match the standards set forth by society (Thompson, van den Berg, Roehrig, Guarda, & Heinberg, 2003). Not surprisingly, using media sources to obtain information about the ideal body appearance and internalizing such messages are associated with heightened levels of disordered eating attitudes and behaviors (Cusumano & Thompson, 1997). High sociocultural pressures to achieve the ideal body can facilitate ED (Pelletier et al., 2004). The mass media is both a transmitter and reinforcer of these sociocultural body ideals (Dittmar, 2005). As such, sociocultural theory provides a conceptual framework to help explain the link between societal pressure and body dissatisfaction (Dittmar, 2005). The sociocultural model “identifies social pressure as the impetus behind an individual's need to conform to body shape standards” that are reinforced in society (Cusumano & Thompson, 1997, p. 701). While media influences on ED can take various forms (e.g., a source of information on the ideal body appearance and how to achieve it, and internalization of these messages), one might expect media pressures (e.g., pressures to attain the ideal body appearance) to strongly influence an individual's tendencies to adopt disordered eating attitudes and behaviors. Thus, the current study was designed to test the hypothesis that media pressures would mediate the associations between two different aspects of the media (source of information and internalization) and bulimic attitudes/tendencies. We focused on bulimic attitudes/tendencies given the prevalence of this disorder among college-age women. 1. Method Participants in this cross-sectional study were 106 (M age = 19.9; 18–22 years) students at a women's college. We collected data during the end of the spring semester from a large survey psychology course, student residences, and athletic teams. Respondents provided written informed consent before completing an anonymous, 20-minute, self-report survey. Respondents from the psychology class received extra credit toward their final grade while participants outside of the class were entered into a raffle with a chance to win various prizes (e.g., iPod, gift certificates). We used the Eating Disorder Diagnostic Scale (EDDS; Stice, Telch & Rizvi, 2000; M = 1.6, SD = 1.7, range, 0–6) to assess disordered eating attitudes and tendencies. Given the focus of the present study, we only used total sum scores from the BN portion of the EDDS. Questions in the following three areas were assessed: a) negative selfevaluation of one's body weight or shape, b) regular eating binges with a large consumption of food and a loss of control when eating, and c) involvement in unhealthy behaviors in response to eating or weight gain. We treated this as a continuous variable in our analyses; thus, higher scores equal higher bulimic attitudes/tendencies. We used the Sociocultural Attitudes Towards Appearance Questionaire-3 (SATAQ-3; Thompson et al., 2003) to measure three dimensions of media influence: (1) Information (“Movies are an important source of information about fashion and being attractive;” 9-items; M = 20.4, SD = 7.0, range, 9–36; α = .94 in the present study), (2) Pressure (“I felt pressure from TV/magazines to have a perfect body;” 7-items; M = 17.4, SD = 6.2, range, 6–28; α = .93 in the present study), and (3) Internalization (“I would like my body to look like the models who appear in magazines;” 9items; M = 21.6, SD = 7.1, range, 9–36; α = .94 in the present study). Participants indicated their level of agreement on these items using a 4-point scale (1 = disagree to 4 = agree). Scores for the SATAQ-3 were derived by summing responses on questions that corresponded with each media subscale. 2. Results We conducted mediation analyses as described by Baron and Kenny (1986). We ran separate mediation tests for each dimension of the media (source of information and internalization) using hierarchical linear regression. As shown in Fig. 1, findings revealed a direct, positive association between the use of the media as a source of information and bulimic attitudes/tendencies; however, this association dropped to non-significance when the mediator variable (media pressures) was added into the model. Media pressures also mediated the association
S.S. O'Riordan, B.L. Zamboanga / Eating Behaviors 9 (2008) 247–250
249
Fig. 1. Mediation effect of media pressure on bulimic attitudes and tendencies. Note. N = 106, ⁎⁎⁎p b .001. Value in parentheses is the beta coefficient for this path after addition of media pressures in the regression model predicting bulimic attitudes/tendencies.
between internalization of the media and bulimic attitudes/tendencies. Sobel tests confirmed a statistically significant influence of these mediation effects (Sobel, 1982). 3. Discussion The steady increase in the prevalence of ED (Stice et al., 1994) among college women (Botta, 1999; Grigg et al., 1996) and the adverse consequences of BN (e.g., kidney failure; congestive heart failure) highlight the importance of ED research in this population. Moreover, the secrecy of bulimic individuals, and the fact that individuals with BN generally do not appear underweight, make it difficult to recognize those who are at risk (Hesse-Biber et al., 2006). Prior research has found the mass media to be a relevant sociocultural correlate of ED (Pelletier, 2004). In the present study, we found that media pressures mediated the association between two aspects of the media (source of information and internalization) and bulimic attitudes and tendencies. Our results support sociocultural theory and suggest that the pressure an individual feels from the media to conform to the ideal body appearance plays a more important role in bulimic attitudes/tendencies than using the media as a source of information or internalizing the messages from the media. The present findings should be considered in light of some limitations. First, our sample was drawn from a women's college, therefore our findings may not generalize to women at co-educational colleges. Second, because we conducted correlational statistics and utilized a cross-sectional study design, no inferences of causality can be made regarding the associations between the media and bulimic attitudes/tendencies. Despite these limitations, our results have potential implications for prevention efforts and future research. College programmers and service providers should develop programs that address (among other factors) college women's perceptions of societal pressures to conform to the ideal body image/type. Furthermore, college health professionals and service providers can also measure such pressures as part of a college health assessment battery to identify and target students who may be at risk for disordered eating attitudes/behaviors. Exactly what factors elevate or decrease the amount of sociocultural pressure an individual perceives from the media remain unclear, therefore future research could explore this issue. Acknowledgements The authors are grateful to Amy Constantine and Jennifer Hockensmith for their editorial assistance on this paper. Special thanks to Dr. Sam Hardy and Janine V. Olthuis for their insightful comments. The authors would also like to
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S.S. O'Riordan, B.L. Zamboanga / Eating Behaviors 9 (2008) 247–250
thank Sheralee Tershner for her assistance with this project and the Office of the Provost at Smith College for their funding support. Portions of this research were presented at the 2006 Annual New England Psychology Association conference. References Baron, R. M., & Kenny, D. A. (1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic and statistical considerations. Journal of Personality and Social Psychology, 51, 1173−1182. Botta, R. A. (1999). Television images and adolescent girls' body image disturbance. Journal of Communication, 49, 22−41. Cusumano, D. L., & Thompson, J. K. (1997). Body image and shape ideals in magazines: Exposure, awareness, and internalization. Sex Roles, 37, 701−721. Dittmar, H. (2005). Vulnerability factors and processes linking sociocultural pressures and body dissatisfaction. Journal of Social and Clinical Psychology, 24, 1081−1087. Grigg, M., Bowman, J., & Redman, S. (1996). Disordered eating and unhealthy weight reduction practices among adolescent females. Preventative Medicine, 25, 748−756. Hawkins, N., Richards, P. S., Granley, H. M., & Stein, D. M. (2004). The impact of exposure to the thin-ideal media image on women. Eating Disorders, 12, 35−50. Hesse-Biber, S., Leavy, P., Quinn, C. E., & Zoino, J. (2006). The mass marketing of disordered eating and eating disorders: The social psychology of women, thinness and culture. Women's Studies International Forum, 29, 208−224. Pelletier, L. G., Dion, S., & Levesque, C. (2004). Can self-determination help protect women against sociocultural influences about body image and reduce their risk of experiencing bulimic symptoms? Journal of Social and Clinical Psychology, 23, 61−88. Sobel, M. E. (1982). Asymptomatic intervals for indirect effects of structural equations models. In S. Leinhart (Ed.), Sociological methodology (pp. 290−312). San Francisco: Jossey-Bass. Stice, E., Schupak-Neuberg, E., Shaw, H. E., & Stien, R. I. (1994). Relation of media exposure to eating disorder symptomatology: An examination of mediating mechanisms. Journal of Abnormal Psychology, 103, 836−840. Stice, E., Telch, C. F., & Rizvi, S. L. (2000). Development and validation of the eating disorder diagnostic scale: A brief self-report measure of anorexia, bulimia, and binge-eating disorder. Psychological Assessment, 12, 123−131. Thompson, J. K., van den Berg, P., Roehrig, M., Guarda, A. S., & Heinberg, L. J. (2003). The sociocultural attitudes towards appearance scale-3 (SATAQ-3): Development and validation. International Journal of Eating Disorders, 35, 293−304.
Eating Behaviors 9 (2008) 247 – 250
Short communication
Aspects of the media and their relevance to bulimic attitudes and tendencies among female college students Siobhan S. O'Riordan ⁎, Byron L. Zamboanga Department of Psychology, Clark Science Center, Smith College Northampton, MA 01063, United States Received 1 December 2006; accepted 16 March 2007
Abstract We examined whether media pressures would mediate the association between two dimensions of the media (source of information and internalization) and bulimic attitudes/tendencies. The study sample consisted of 106 female college students (M age = 19.9; range = 18–22). Participants completed anonymous, self-report measures on media influences on body image and appearance as well as disordered eating attitudes/behaviors. Findings showed that the association between two dimensions of the media (source of information and internalization) and bulimic attitudes/tendencies was mediated by perceived media pressures. Such findings highlight the significant influence of media pressures on bulimic attitudes/tendencies. Future research and prevention implications are discussed. © 2007 Published by Elsevier Ltd. Keywords: Bulimia Nervosa; Media; Eating disorders
In American society, there is a strong emphasis placed on body shape and appearance (Grigg, Bowman, & Redman, 1996). Unfortunately, the ideal body type/image encouraged by society is often ultra-thin and unrealistic and may therefore contribute to the prevalence of body distortion. These social influences are linked to disordered eating attitudes and behaviors, such as Bulimia Nervosa (BN) (Cusumano & Thompson, 1997). Prior research suggests that the prevalence of BN has increased and that nearly 3 out of 100 women are diagnosed with the disorder (Botta, 1999). According to Grigg et al. (1996), BN most commonly occurs at the end of adolescence, particularly among U.S. college students (Pelletier, Dion, & Levesque, 2004). The adverse health consequences of BN can include, but are not limited to, kidney failure and congestive heart failure (Hesse-Biber, Leavy, Quinn, & Zoino, 2006). Eating Disorders (ED) as a whole are more prevalent in women than men; in fact, 90–95% of those diagnosed with an ED are women (Hesse-Biber et al., 2006). Altogether, the adverse health consequences and the increased frequency of ED in this population highlight the need for continued research on disordered eating attitudes and behaviors. There are a number of sociocultural factors, such as the mass media, that contribute to the onset and maintenance of ED. Different aspects of the media can influence an individual's body perceptions. Prior research ⁎ Corresponding author. E-mail addresses: [email protected] (S.S. O'Riordan), [email protected] (B.L. Zamboanga). 1471-0153/$ - see front matter © 2007 Published by Elsevier Ltd. doi:10.1016/j.eatbeh.2007.03.004
248
S.S. O'Riordan, B.L. Zamboanga / Eating Behaviors 9 (2008) 247–250
suggests that many women use the media for body image information and strategies to attain the ideal body type/ image (Botta, 1999; Stice, Schupak-Neuberg, Shaw, & Stein, 1994). For example, the ideal body type/image presented by the media is generally 15% smaller than the average woman (Hawkins, Richards, Granley, & Stein, 2004). In fact, Stice et al. (1994) found that individuals with BN learned their purging techniques directly from the media. Furthermore, some individuals internalize the messages in the media regarding the ideal body appearance; consequently, individuals modify their own body and behavior to match the standards set forth by society (Thompson, van den Berg, Roehrig, Guarda, & Heinberg, 2003). Not surprisingly, using media sources to obtain information about the ideal body appearance and internalizing such messages are associated with heightened levels of disordered eating attitudes and behaviors (Cusumano & Thompson, 1997). High sociocultural pressures to achieve the ideal body can facilitate ED (Pelletier et al., 2004). The mass media is both a transmitter and reinforcer of these sociocultural body ideals (Dittmar, 2005). As such, sociocultural theory provides a conceptual framework to help explain the link between societal pressure and body dissatisfaction (Dittmar, 2005). The sociocultural model “identifies social pressure as the impetus behind an individual's need to conform to body shape standards” that are reinforced in society (Cusumano & Thompson, 1997, p. 701). While media influences on ED can take various forms (e.g., a source of information on the ideal body appearance and how to achieve it, and internalization of these messages), one might expect media pressures (e.g., pressures to attain the ideal body appearance) to strongly influence an individual's tendencies to adopt disordered eating attitudes and behaviors. Thus, the current study was designed to test the hypothesis that media pressures would mediate the associations between two different aspects of the media (source of information and internalization) and bulimic attitudes/tendencies. We focused on bulimic attitudes/tendencies given the prevalence of this disorder among college-age women. 1. Method Participants in this cross-sectional study were 106 (M age = 19.9; 18–22 years) students at a women's college. We collected data during the end of the spring semester from a large survey psychology course, student residences, and athletic teams. Respondents provided written informed consent before completing an anonymous, 20-minute, self-report survey. Respondents from the psychology class received extra credit toward their final grade while participants outside of the class were entered into a raffle with a chance to win various prizes (e.g., iPod, gift certificates). We used the Eating Disorder Diagnostic Scale (EDDS; Stice, Telch & Rizvi, 2000; M = 1.6, SD = 1.7, range, 0–6) to assess disordered eating attitudes and tendencies. Given the focus of the present study, we only used total sum scores from the BN portion of the EDDS. Questions in the following three areas were assessed: a) negative selfevaluation of one's body weight or shape, b) regular eating binges with a large consumption of food and a loss of control when eating, and c) involvement in unhealthy behaviors in response to eating or weight gain. We treated this as a continuous variable in our analyses; thus, higher scores equal higher bulimic attitudes/tendencies. We used the Sociocultural Attitudes Towards Appearance Questionaire-3 (SATAQ-3; Thompson et al., 2003) to measure three dimensions of media influence: (1) Information (“Movies are an important source of information about fashion and being attractive;” 9-items; M = 20.4, SD = 7.0, range, 9–36; α = .94 in the present study), (2) Pressure (“I felt pressure from TV/magazines to have a perfect body;” 7-items; M = 17.4, SD = 6.2, range, 6–28; α = .93 in the present study), and (3) Internalization (“I would like my body to look like the models who appear in magazines;” 9items; M = 21.6, SD = 7.1, range, 9–36; α = .94 in the present study). Participants indicated their level of agreement on these items using a 4-point scale (1 = disagree to 4 = agree). Scores for the SATAQ-3 were derived by summing responses on questions that corresponded with each media subscale. 2. Results We conducted mediation analyses as described by Baron and Kenny (1986). We ran separate mediation tests for each dimension of the media (source of information and internalization) using hierarchical linear regression. As shown in Fig. 1, findings revealed a direct, positive association between the use of the media as a source of information and bulimic attitudes/tendencies; however, this association dropped to non-significance when the mediator variable (media pressures) was added into the model. Media pressures also mediated the association
S.S. O'Riordan, B.L. Zamboanga / Eating Behaviors 9 (2008) 247–250
249
Fig. 1. Mediation effect of media pressure on bulimic attitudes and tendencies. Note. N = 106, ⁎⁎⁎p b .001. Value in parentheses is the beta coefficient for this path after addition of media pressures in the regression model predicting bulimic attitudes/tendencies.
between internalization of the media and bulimic attitudes/tendencies. Sobel tests confirmed a statistically significant influence of these mediation effects (Sobel, 1982). 3. Discussion The steady increase in the prevalence of ED (Stice et al., 1994) among college women (Botta, 1999; Grigg et al., 1996) and the adverse consequences of BN (e.g., kidney failure; congestive heart failure) highlight the importance of ED research in this population. Moreover, the secrecy of bulimic individuals, and the fact that individuals with BN generally do not appear underweight, make it difficult to recognize those who are at risk (Hesse-Biber et al., 2006). Prior research has found the mass media to be a relevant sociocultural correlate of ED (Pelletier, 2004). In the present study, we found that media pressures mediated the association between two aspects of the media (source of information and internalization) and bulimic attitudes and tendencies. Our results support sociocultural theory and suggest that the pressure an individual feels from the media to conform to the ideal body appearance plays a more important role in bulimic attitudes/tendencies than using the media as a source of information or internalizing the messages from the media. The present findings should be considered in light of some limitations. First, our sample was drawn from a women's college, therefore our findings may not generalize to women at co-educational colleges. Second, because we conducted correlational statistics and utilized a cross-sectional study design, no inferences of causality can be made regarding the associations between the media and bulimic attitudes/tendencies. Despite these limitations, our results have potential implications for prevention efforts and future research. College programmers and service providers should develop programs that address (among other factors) college women's perceptions of societal pressures to conform to the ideal body image/type. Furthermore, college health professionals and service providers can also measure such pressures as part of a college health assessment battery to identify and target students who may be at risk for disordered eating attitudes/behaviors. Exactly what factors elevate or decrease the amount of sociocultural pressure an individual perceives from the media remain unclear, therefore future research could explore this issue. Acknowledgements The authors are grateful to Amy Constantine and Jennifer Hockensmith for their editorial assistance on this paper. Special thanks to Dr. Sam Hardy and Janine V. Olthuis for their insightful comments. The authors would also like to
250
S.S. O'Riordan, B.L. Zamboanga / Eating Behaviors 9 (2008) 247–250
thank Sheralee Tershner for her assistance with this project and the Office of the Provost at Smith College for their funding support. Portions of this research were presented at the 2006 Annual New England Psychology Association conference. References Baron, R. M., & Kenny, D. A. (1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic and statistical considerations. Journal of Personality and Social Psychology, 51, 1173−1182. Botta, R. A. (1999). Television images and adolescent girls' body image disturbance. Journal of Communication, 49, 22−41. Cusumano, D. L., & Thompson, J. K. (1997). Body image and shape ideals in magazines: Exposure, awareness, and internalization. Sex Roles, 37, 701−721. Dittmar, H. (2005). Vulnerability factors and processes linking sociocultural pressures and body dissatisfaction. Journal of Social and Clinical Psychology, 24, 1081−1087. Grigg, M., Bowman, J., & Redman, S. (1996). Disordered eating and unhealthy weight reduction practices among adolescent females. Preventative Medicine, 25, 748−756. Hawkins, N., Richards, P. S., Granley, H. M., & Stein, D. M. (2004). The impact of exposure to the thin-ideal media image on women. Eating Disorders, 12, 35−50. Hesse-Biber, S., Leavy, P., Quinn, C. E., & Zoino, J. (2006). The mass marketing of disordered eating and eating disorders: The social psychology of women, thinness and culture. Women's Studies International Forum, 29, 208−224. Pelletier, L. G., Dion, S., & Levesque, C. (2004). Can self-determination help protect women against sociocultural influences about body image and reduce their risk of experiencing bulimic symptoms? Journal of Social and Clinical Psychology, 23, 61−88. Sobel, M. E. (1982). Asymptomatic intervals for indirect effects of structural equations models. In S. Leinhart (Ed.), Sociological methodology (pp. 290−312). San Francisco: Jossey-Bass. Stice, E., Schupak-Neuberg, E., Shaw, H. E., & Stien, R. I. (1994). Relation of media exposure to eating disorder symptomatology: An examination of mediating mechanisms. Journal of Abnormal Psychology, 103, 836−840. Stice, E., Telch, C. F., & Rizvi, S. L. (2000). Development and validation of the eating disorder diagnostic scale: A brief self-report measure of anorexia, bulimia, and binge-eating disorder. Psychological Assessment, 12, 123−131. Thompson, J. K., van den Berg, P., Roehrig, M., Guarda, A. S., & Heinberg, L. J. (2003). The sociocultural attitudes towards appearance scale-3 (SATAQ-3): Development and validation. International Journal of Eating Disorders, 35, 293−304.